Article
Open Access
Volume 3 · Issue 1 · 2023
pp. 33–39
Prognostic and Predictive Value of Baseline Hypogammaglobulinemia for Chronic Lymphocytic Leukemia Prognosis and Complications
Fatih Kuş1, Murat Bektaş2, Naci Senkal1, Yunus Catma1, Fatih Atalah1, Arif Akyildiz1, Şule Gumurdu3, Meliha Nalcaci4
1
Department of Internal Medicine, Istanbul Medicine Faculty, Istanbul University, Istanbul, Türkiye
2
Department of Rheumatology, Istanbul Medicine Faculty, Istanbul University, Istanbul, Türkiye
3
Medical Student, Istanbul Medicine Faculty, Istanbul University, Istanbul, Türkiye
4
Department of Hematology, Istanbul Medicine Faculty, Istanbul University, Istanbul, Türkiye
Abstract
Objectives: Hypogammaglobulinemia has been reported to predispose to infectious complications and is associated with poor prognosis. Therefore, we aimed to evaluate the predictive value of hypogammaglobulinemia for infectious complications by revealing the frequency, prognostic value in newly diagnosed CLL patients.
Methods: We retrospectively analyzed 74 CLL patients. Electronic medical records, as well as patients’ files, were screened to collect the presented data. Risk assessment was performed using current Rai and Binet staging systems. Results: Among 74 patients included in this study, 52 (70.3%) were male and 22 (29.7%) female. The most common chromosomal abnormalities was the 13q deletion (27.0%). Hypogammaglobulinemia was found in 24.3% (n=18) of the patients. The overall survival was 54,1 months. Most patients had advance disase. In our study, the incidence of infection was determined as 13.5% (n=10), and the mortality incidence was 8.1% (n=6). A positive correlation was detected between IgA levels and mean survival time (p=0.022). The mean IgG levels of patients with 17p deletion were found significantly decreased (p=0,015). Furthermore, frequency of infection in patients with hypogammaglobulinemia (33,3% vs. 7,3%; p=0.005) and mortality rate in patients with infection (50,0% vs. 3,8%; p=0.002) were found to be significantly increased. Conclusion: We detected significantly increased infection frequency associated with hypogammaglobulinemia in addition to increased infection-related mortality rates. A significant correlation between increased IgA levels and pro-longed survival was shown. Moreover, significantly decreased IgG levels were found in patients with 17p deletion, which is a well-known poor prognostic factor.
Methods: We retrospectively analyzed 74 CLL patients. Electronic medical records, as well as patients’ files, were screened to collect the presented data. Risk assessment was performed using current Rai and Binet staging systems. Results: Among 74 patients included in this study, 52 (70.3%) were male and 22 (29.7%) female. The most common chromosomal abnormalities was the 13q deletion (27.0%). Hypogammaglobulinemia was found in 24.3% (n=18) of the patients. The overall survival was 54,1 months. Most patients had advance disase. In our study, the incidence of infection was determined as 13.5% (n=10), and the mortality incidence was 8.1% (n=6). A positive correlation was detected between IgA levels and mean survival time (p=0.022). The mean IgG levels of patients with 17p deletion were found significantly decreased (p=0,015). Furthermore, frequency of infection in patients with hypogammaglobulinemia (33,3% vs. 7,3%; p=0.005) and mortality rate in patients with infection (50,0% vs. 3,8%; p=0.002) were found to be significantly increased. Conclusion: We detected significantly increased infection frequency associated with hypogammaglobulinemia in addition to increased infection-related mortality rates. A significant correlation between increased IgA levels and pro-longed survival was shown. Moreover, significantly decreased IgG levels were found in patients with 17p deletion, which is a well-known poor prognostic factor.
Keywords: Chronic lymphocytic leukemia, hypogammaglobulinemia, prognosis
